Provider Demographics
NPI:1720648157
Name:COBB, NATHAN ANDREW (DO)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ANDREW
Last Name:COBB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1110 HIGHLANDS PLAZA DR E STE 220
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1351
Mailing Address - Country:US
Mailing Address - Phone:314-273-0195
Mailing Address - Fax:
Practice Address - Street 1:1110 HIGHLANDS PLAZA DR E STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1351
Practice Address - Country:US
Practice Address - Phone:314-273-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5151013682207Q00000X
MI5101026044207Q00000X
MO2022020790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine